Heme Onc U world

Question 1

how does vitamin K affect clotting factors

Answer 1

essential factor in GAMMA CARBOXYLATION

Question 2

patient in heparin has brain bleed…what to do

Answer 2

stop heparin

give PROTAMINE SULFATE

Question 3

patient on warfarin has brain bleed….what to do

Answer 3

stop warfarin
give FFP (has all clotting factors)
vitk supplementation takes days, not useful for acute setting

Question 4

what medication given post STEMI can cause reperfusion arrhythmias

Answer 4

tPA

arryhtmias typically benign and not associated with increased mortality (accelerated idioventricular rhythm)

Question 5

MOA of boronic acid containing dipeptide in treating multiple myeloma

Answer 5

proteasome inhibitors….cause accumulation of toxic intracellular and proAPOPTOTIC proteins which will increase apoptosis in neoplastic plasma cells

Question 6

MOA LMWH

Answer 6

binds to antithrobin III and increases its effectiveness

antithrombin 3 will undergo conformational change and inhibit factor Xa

Question 7

cancer mediator responsible for cachexia

Answer 7

TNF a

Question 8

osteosarcoma. breast cancer, brain tumor adenocortical carcinoma, leukemia

Answer 8

LI fraumeni
mutation in tp53
autosomal dominant (second hit hypothesis)

Question 9

MOA for human multi drug resistance (to chemo agents)

Answer 9

MDR1 gene codes for P-glycoprotein which codes for ATP dependent efflux pump (pumps out lots of different hydrophobic compounds, esp chemo agents) and reduces their action

Question 10

anemia associated with alcoholism

Answer 10

folate!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! GET FUCKED UP AND FUCK UP YOUR FOLATE BITCH

Question 11

dysphagia, anemia, spooning ot nails, shiny tongue, koilonychia.. how to treat

Answer 11

plummer vinson

give iron!

Question 12

enlarged painles lymphnode that waxes and wanes (fluctuates in size but never disappears)
translocatioN?

Answer 12

t(14;18) follicular lymphoma

bcl2 oncogene